Reforms to phased dispensing and enhanced medicines supports - Leitrim comment

Leitrim councillor, James Gilmartin has welcomed the announcement of significant reforms to phased dispensing arrangements and the introduction of a new patient-centred medicines optimisation support framework under the Community Pharmacy Agreement (CPA).

The reforms, agreed between the Department of Health, the Health Service Executive (HSE) and the Irish Pharmacy Union (IPU), are designed to "strengthen supports for vulnerable General Medical Services (GMS) patients while ensuring a more flexible, sustainable and clinically driven approach to medicines management in the community," a statement to the Leitrim Observer said.

It continued: "A central feature of the reform is the move away from rigid phased dispensing fees to a more flexible, patient-centred model. This approach empowers pharmacists to use their professional judgement to determine the most appropriate supports for patients, particularly those with complex or additional needs."

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Importantly, Cllr Gilmartin said that "no funding is being removed from community pharmacies. Instead, the reforms focus on redirecting resources to patients who genuinely need enhanced supports, while enabling pharmacists to deliver more responsive frontline care."

Under the new arrangements:

• Any patient who was receiving phased dispensing or blister packs free of charge prior to August 2025 will continue to receive these supports.
• Blister packs will remain a last resort, in line with international evidence, due to associated risks including reduced patient autonomy and potential safety concerns.
• Pharmacists will have greater discretion to provide tailored supports such as medication reminder systems, administration charts, instalment dispensing, and adjustments to facilitate the use of original packaging.

Where clinically necessary, blister packs will continue to be provided free of charge to eligible medical card patients within defined cohorts.

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The reforms are supported by significant State investment, including:

• €20 million already invested in increased standard dispensing fees, backdated to September 2025;
• €20–24 million to fund a new medicines optimisation fee for medical card patients; and
• €2.5 million to support enhanced dispensing arrangements for patients who require medication more than once per week. 

These changes will come into effect from 1 June 2026.

Cllr Gilmartin said:

“This is a very positive and patient-focused reform that strengthens the role of community pharmacy at the heart of our healthcare system. It ensures that those who rely on existing supports will continue to receive them, while introducing a more flexible and clinically appropriate model for the future.

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Crucially, no funding is being removed from pharmacies. Instead, we are targeting resources more effectively—directing supports to those who need them most and enabling pharmacists to use their professional expertise to deliver the best possible care.

By reducing unnecessary rigidity and administrative burden, these reforms will allow pharmacists to focus on what matters most: supporting patients, improving medication safety, and delivering high-quality care in the community.”

Cllr Gilmartin also acknowledged "the collaborative work of all parties involved in reaching the agreement, noting that it represents an important step forward in modernising pharmacy services and improving outcomes for patients across the country."